What is the most important data?

What are the top three most important data for the success of our treatment? I know they're all important or they wouldn't be on SleepyHead.

Or what combination for a more stable therapy?


I had a pressure pulse reading of 113 last night and 13 the night before. Is there concern? I've had it as low as 7. I know if you don't have a pulse, you wont have to

worry about it. Is the high reading because of low pressure or because the presslure was high?

Thank you.
George

Leak is pretty important, and should be considered in combination with pressure. The count and timing of logged apnea and hypopnea events can also be useful.

I wouldn't be concerned about your pressure pulse count. Your counts are lower than my average range; I wasn't even concerned about having 299 of them (a touch higher than my usual count) in a bit under seven hours earlier this week. What triggers the pulses is a brief pause in breathing that starts the machine into its obstructive-or-clear-airway categorization, and this starts before the pause is long enough to count as a logable apnea event.

The pressure pulse count in SH is just the number of times the System One sent out a so-called "pressure pulse" to test whether your upper airway is open or closed.

The "pressure pulse" itself is just a very brief 2cm increase in pressure. But the machine's program uses the response (in the flow wave) to this very brief increase in pressure to decide whether your upper airway is clear (not collapsed) or obstructed (collapsed).

Typically the machine sends out these pressure pulses whenever it thinks it might be detecting the beginning of an apnea: In other words, if there's been no air movement in or out of your lungs for about 5 or 6 seconds, then the machine is likely to send out a pressure pulse. In a short apnea, there may only be one or two pressure pulses sent. In a really long apnea, there may be a whole slew of pressure pulses since the machine will keep sending them out every 5 or 6 seconds until the end of the apnea.

The machine can also send out pressure pulses when it's having a tough time detecting your breathing for some reason. For example, if there's a large enough leak the machine might loose track of your breathing patterns and send out a bunch of pressure pulses in an attempt to figure out whether you are still breathing through the mask or have removed the mask.

To answer your big question:

What are the top three most important data for the success of our treatment?

In my humble opinion, the three most important things to track for successful treatment are (in this order):

1) How do you feel? We all have our good and bad days. But if we're not feeling decent enough to function on most days, then something's wrong. It might not be the OSA or the CPAP, but feeling bad with a great AHI and a great leak line means you need to still do some problem solving to figure out what's going wrong.

2) The AHI data. A snapshot of whether the machine is doing its job each night. Again, we all have good and bad nights. But if that AHI is consistently above 5, that points to a problem even if you are feeling better than before starting CPAP. And talking to the doc is in order.

3) The leak line. Large leaks can compromise therapy and make the AHI number suspect. Large fluctuations in leaks can lead to discomfort and fragmented sleep, which in turn directly affects how you feel during the day. In SH, the leak line is never going to look flat because JediMark has chosen to use a vertical axis scale that shows all the small bumps. But typically if that leak line lies inside a band that is no more than 10 units wide in the vertical direction, it's usually OK.

Thanks for your reply, Robysue and tetragon.

I disagree with Robysue...

The most important data is

#1 How do you feel?

#2 How do you feel?

#3 How do you feel?

If you answer the top 3 with anything less than "absolutely great," then you can review your stress levels and your attitude and try to figure out what is going on in your life.

After all of that, then the AHI and Leak data may help.

HoseCrusher wrote:I disagree with Robysue...

The most important data is

#1 How do you feel?

#2 How do you feel?

#3 How do you feel?

If you answer the top 3 with anything less than "absolutely great," then you can review your stress levels and your attitude and try to figure out what is going on in your life.

After all of that, then the AHI and Leak data may help.

Unfortunately, lots of people with severe apnea report they feel fine. If you feel bad, that's important, but feeling good is not an "all clear" signal.

I notice no one entered hours used. I know; the nasty "C" word!
Hours used probably correlates with hours slept; and is relevant--although no more than AHI, leak and 95% pressure--IMHO.
Time started is an indicator of sleep hygiene.--I notice a close relation to how I feel the next day.

Just my opinion, but I thought that a combination of AHI<5, AI<1, mask on (hour used) >7 and wake up <1 have some impact how I feel when I wake up in the morning.
I just push start button when I read to fall asleep and stop machine when I can't recover my sleep during the night.

The most important data is

#1 How do you feel?

#2 How do you feel?

#3 How do you feel?

Can't agree with this. I'm one who felt OK before and feel about the same now. I just hope that I am getting long-term benefits.

I find the machine is sensitive to my awake breathing. I often spend an hour or more trying to get back to sleep after waking at 3 or 4 in the AM. During this time there are apt to be many more Pressure Pulses than an equivalent sleeping period.

I'd say AHI (hypopnea, obstructive events), that should be under 5, leakage because if that is happening a lot, you aren't getting the pressure you need to stint your airway open, probably pulse ox if you have an oximeter.

Gabe wrote:What are the top three most important data for the success of our treatment? I know they're all important or they wouldn't be on SleepyHead.

Or what combination for a more stable therapy?


I had a pressure pulse reading of 113 last night and 13 the night before. Is there concern? I've had it as low as 7. I know if you don't have a pulse, you wont have to

worry about it. Is the high reading because of low pressure or because the presslure was high?

Thank you.
George